Table 3.
Possible motives and barriers related to participating in GCT
| Perspective of patientsa | Perspective of healthcare professionalsb |
|---|---|
| Barriers | |
| Cultural factors | |
| Cancer taboo, cancer as a death sentence | Cancer taboo, more secrecy |
| Lack of familiarity of healthcare professional with migrant culture of patients | |
| Limited knowledge of family cancer history | Limited knowledge of family cancer history |
| Cancer as an unknown disease | More difficulties in accessing family history |
| Limited information given to children (in country of origin), not informed when going abroad | |
| Fewer close relationships with second degree family members (Moroccan women) | |
| Nondisclosure to family members to spare them grief (cancer taboo) | Nondisclosure wish of cancer diagnosis by family members |
| Psychosocial factors | |
| Lacking social support, disagreement of family members, especially daughters, to obtain GCT | |
| Anxiety of the patient | Different mind-set |
| Patient-physician communication | |
| Language difficulties | Language barriers |
| “Patient not a communication partner” (translator-physician) | |
| Relying on translator/“not sure translation is correct” (nurses) | |
| Lack of familiarity with health care | Limited knowledge about breast cancer and health care in T/M patients |
| Limited knowledge about breast cancer and illness in general | Poorly educated; you have to teach the basics of health and diseases first |
| Difficulties in formulating the right questions | Other questions of Turkish/Moroccan patients |
| Being “numb” after disclosure of breast cancer diagnosis | |
| Afraid to ask questions | Fewer questions of Turkish/Moroccan patients |
| Too little time with surgeon | Consultations take more time, referral to GCT might be postponed/delayed and “forgotten” |
| Doctor’s role, faith is in their hands Doctor’s advice taken |
Different contact with migrant patients; doctor is seen as the “healer” |
| Motives | |
| Preventive options for oneself | In general, positive attitude to GCT observed |
| Knowing whether family members, especially children, would be at risk; to gain reassurance | |
| Religious belief; according to Islam/Allah, you have a duty to investigate in order to become well | |
| Doctor’s advice taken | More assertiveness among younger patients |
| Support of nurse practitioners referring patients to GCT | |
| Making patients aware of the possibilities, “they should make GCT obligatory” | |
aBased on data from both the interviews and the focus groups with Turkish and Moroccan breast cancer patients
bBased on the focus groups with medical professionals: surgeons, a radiation oncologist, and nurse practitioners